"Watson claims he then discovered a second time that his mother was
being given medicine without her consent or knowledge. No formal
complaint was ever made, no investigation was ever held, but at Watson's
insistence, his mother was never covertly sedated again. In 1999 she
contracted cancer, and this time - to her son's surprise - she gave her
own consent for pain relief. Although by then in an advanced state of
dementia she was still quite capable, he points out, of making a
"treatment decision" for herself. But as the pain relief levels
increased, her mental condition deteriorated. "She would say, 'Where is
Hunter?' I'd say, 'I'm Hunter.' She'd look puzzled. I'd say, 'the boy
you used to look after', and that seemed to reassure her. She'd say,
'Yes, and now you're looking after me.'" In January 2000, Helen Watson
passed peacefully away.

But by then her son had begun his campaign against covert medication,
which has now taken him all the way to the Scottish parliament. New
guidelines are under review, and he hopes to see the practice explicitly
outlined in the near future. "I would like," he says simply, "Scotland
to be the first country in the world to say, 'Look, this is wrong - it
shouldn't happen.'"

He must have made himself quite a thorn in the side of many
authorities - he is, in his own words, "a bit of a serial campaigner" -
but even he seems slightly amazed that his long campaign may at last be
about to rewrite the rights of the elderly. I ask if he has been
fighting all these years for his mother, as a tribute, or memorial, to
her. He looks at me in quiet astonishment.

Received by Email from Hunter Watson, Mental Health Human Rights Campaigner, on 7 February 2018:

"Good afternoon,

In case it might be of interest to you, I attach a
copy of my response to the ongoing consultation regarding the making of
amendments to the Adults with Incapacity Act to ensure its compliance
with the UNCRPD. Some proposed amendments I welcome, but a few I oppose.
In particular I am opposed to the proposal that the scope of a section
47 certificate should be extended to authorise a doctor to have a person
detained in hospital for a period of 28 days or more without,
apparently, any right of appeal. In my opinion such a provision would
comply with neither the ECHR nor the UNCRPD.

In my opinion also, the opportunity should be taken to do as has
already been done in Northern Ireland, i.e. to introduce legislation
which is applicable to all persons, certainly all adults, who appear to
have lack of legal capacity with respect to some matters.

"Now that the final day has arrived on which
signatures can be added to my petition PE01667 on mental health and
incapacity legislation I have produced the attached paper which not only
makes the case for a wide review being necessary but also provides
reasons for my being hopeful that one will take place. You might find it
of interest.

Closing Date for Online Petition:
03 August 2017
"Calling on the Scottish Parliament to urge the Scottish Government
to conduct a wide review Scottish mental health and incapacity
legislation and, when doing so, to take due account of recent
developments in international human rights law."

"In 1997 I began writing to my MP in an attempt to persuade Parliament
to legislate to ensure that antipsychotic drugs were not concealed in
the food or drink of elderly care home residents. After the
establishment of the Scottish Parliament in 1999, I began writing to
MSPs in an attempt to achieve the same aim. When it became apparent that
this approach was not going to be successful I submitted a petition to
the Public Petitions Committee. This petition, number PE867
(http://archive.scottish.parliament.uk/business/petitions/docs/PE867.htm),
generated great media interest because it had not been generally
realised that drugs were being concealed in the food or drink of some
care home residents: I was interviewed on both radio and television and
the story was covered in the UK press. Regrettably, this petition was
unsuccessful. It was assumed that my concerns would be addressed by
revising the Code of Practice for the Adults with Incapacity Act.
Basically, the revision implied that covert medication is permissible
provided that it is done in accordance with the provisions of the Adults
with Incapacity (Scotland) 2000 Act (the AWI Act). However, given
developments in the field of human rights since the passage of that Act,
it would seem to be now appropriate to review it.

In 2008 I was
made aware of one particular case which made it clear that the Mental
Health (Scotland) Act 2003 (the 2003 Act) was not working as well as the
Scottish Parliament had expected. Basically, it suffers from the same
flaw as does Part 5 of the AWI Act. In each case, too much power is
given to health professionals who, like the rest of us, are not
infallible. Nor do they always adhere to the laudable principles which
are supposed to underpin both the AWI and the 2003 Act. As a
consequence, many of the people who are treated under the provisions of
those Acts have their human rights violated. Because of my concerns
about the 2003 Act, and the absolute refusal of the Scottish Government
to act to address those, I submitted petition PE01494 which called for
the Scottish Parliament to urge the Scottish Government to amend the
Mental Health (Care and Treatment) (Scotland) Act 2003 to ensure that it
is compatible with the European Convention on Human Rights. Although I
and the person who seconded my petition were both permitted to address
the Public Petitions Committee and although that Committee gave various
bodies and individuals an opportunity to submit evidence, the Committee
agreed to close my petition without discussing it. I was informed that
it agreed to do this as the consequence of an instruction from a senior
official or civil servant.

The Mental Health (Scotland) Act 2015
reflected a limited review of the 2003 Act that was based upon the 2009
McManus Report and which was concerned largely with administrative
rather than with human rights issues. In spite of calls from the General
Assembly, from the Labour Party's health spokesperson and others, the
Scottish Government declined to widen the scope of that legislation. It
is noteworthy that the Scottish Government chose not to give due
consideration to the submission made by the Scottish Human Rights
Commission (SHRC) to the Scottish Parliament’s Health and Sport
Committee: http://www.scottish.parliament.uk/S4_HealthandSportCommittee/Inquiries/MHB027_-_SHRC.pdf

In that submission, it is stated that the relevant law includes the
"Scotland Act 1998 which requires that all legislation of the Scottish
Parliament must be compatible with ECHR rights. It also requires
that Scottish Ministers must observe and implement the UK's other
international obligations, which includes obligations under
international human rights treaties the UK has ratified. There are
several international human rights treaties that have application to
mental health and mental disorder. This submission focusses on the UN
Convention on the Rights of Persons with Disabilities". (My italics).

The
Scottish Government should examine the possibility that if Scottish
mental health and incapacity legislation is not amended to take due
account of those judgments of the European Court of Human Rights to
which I make reference in my paper entitled "Important Court Judgments
2" then it will not be ECHR compatible as is required by the Scotland
Act.My paper also contains relevant judgments of domestic courts. These have established case-law which makes clear that an adult with capacity can only be treated with that adult's informed consent and that there must be a presumption of capacity.
Among the cases to which reference is made is Montgomery v Lanarkshire
Health Board, 2015. Comments on this case appeared in the May 2017
edition of the BMJ. Among those comments is the following: "The
doctor might think that disclosure of certain information could lead the
patient to a decision that is not in their best interests, as was true
in the Montgomery case. But the ethical and legal position is clear:
doctors must not withhold information simply because they disagree with
the decision the patient is likely to make if given the information".

The
need to provide full information about risks and to not assume that
there is a complete lack of decision-making capacity is of particular
importance when a doctor prescribes an antipsychotic drug for a person
with dementia. The administration of an antipsychotic drug to such a
person, especially if carried out for a significant period, increases
the risk that that person will die prematurely or have a stroke.

In a 2009 report by Professor Sube Banerjee about the use of antipsychotic drugs for people with dementia it was stated "The
use of these drugs in those with dementia has substantial clinical risk
attached, including a conservative estimate of 1,800 extra deaths and
820 extra serious adverse events such as stroke per year". (Numbers presumably referred to England and Wales.)

In
a 2014 report prepared by the Mental Welfare Commission for Scotland
(MWC) it was noted that of the 336 dementia patients in the 52 NHS units
surveyed 166 patients (49%) were being given antipsychotic medication.
The MWC commented "While this might be helpful in relieving symptoms
such as hallucinations, delusions, agitation or aggression there are
known risks for people with dementia. All antipsychotic medications
increase the risk of stroke or death, many can impair mobility and
increase the risk of falls".In June 2010 there was published Scotland's National Dementia Strategy. In section 97 of the strategy it is stated "This
strategy is making a commitment to a reduction in the level of
prescription (of psychoactive medication) during 2011 and a further
reduction for future years".

Regrettably the production of strategies is totally ineffective if they can be ignored with impunity: the document entitled "Medicines used in Mental Health"
reveals that for the period 2009/10 to 2015/16 all NHS Boards showed an
increased prescribing of antipsychotic drugs. Although the data does
not indicate whether this increased prescribing applied to those with
dementia, there can be no assumption that it did not.

In May 2017 there was published a report entitled "Scotland's Mental Health and Capacity Law: the Case for Reform".
It was produced jointly by the Centre for Mental Health & Capacity
Law and the Mental Welfare Commission for Scotland. This report notes
that," ... in order to ensure compliance with developing
international human rights standards ... there is a need to revisit and,
where necessary reframe, our mental health and capacity law". The
report draws attention to the possibility of small changes being made to
the existing legislation prior to the production of a completely new
and unified Act.Account should also be taken of the UK
submission to the committee which monitors compliance with the
Convention on the Rights of Persons with Disabilities (CRPD) within
those countries which have ratified and hence which agreed to comply
with that international human rights treaty. Among the issues raised
are the use of chemical restraint and the abuse of people in residential
care.

If legislation were enacted which took full account of
recent relevant developments in the field of human rights then it is
likely it would follow that:

doctors could no longer prescribe that unwanted drugs be concealed in the food or drink of care home residents;

care home residents could no longer be given potentially harmful drugs as chemical restraint;

mental
health patients could no longer be held down and injected with
psychiatric drugs against their will; nor could they continue to be
given ECT even though they resist or object to that treatment.

"In the attached paper I suggest that the Scottish
Government might place too much weight on advice from experts when it
considers the need to make significant changes to Scottish mental health
and incapacity legislation. One acknowledged expert in the field of
mental health is the consultant psychiatrist Dr David Christmas. I have
no idea whether he ever advises the Government about mental health and
incapacity matters. However, if he does then it is possible that some of
the advice which he provides might be misleading. In the attached paper
I explain why I am of this opinion. A copy of the paper has been sent
to Dr Christmas so that he can comment if he is of the opinion that I
have been misrepresenting any of the statements which I have attributed
to him, statements which I seem to recall that he made at the CPG (Cross Party Group) meeting on mental health that was held on 26 April 2017.

At the end of this post are included two papers that were submitted ahead of the Cross Party meeting: a paper by me entitled “May it be granted the older you are” and a paper by Mr Hunter Watson entitled “Psychoactive Medications”.

I have been to quite a number of Scottish Parliamentary Committee
meetings but this was the first Cross Party Meeting that I have
attended. How welcome it was to see such a good turn out with a packed
committee room. I am inclined to conclude that this indicates how
important it is that we value our older generation. It was however
unfortunate that other parliamentary business meant that various
parliamentarians had to absent themselves.

Given that opportunities for anyone to raise discussion, at
parliamentary level, about the Scottish Government’s ‘Ten Year Vision’
may not come along very often, I felt it was important, as the only NHS
psychiatrist for older adults at this Cross Party meeting, to do my best
to put forward the experiences of my patients.

I was very impressed that the convener, Sandra White, MSP made sure
that as many voices as possible were heard at the meeting. I wrote to
thank her for this.

I was particularly struck by the compelling and worrying testimonies
of Rosemary Carter and Dianna Manson whose experiences as older adults
with mental health issues remind us starkly how important it is that
policy makers consider very carefully the consequences of visions set
for the years ahead.

Rosemary Carter highlighted her experience of how the dominance of
cognitive assessments in my profession has reduced capacity to care for
those who have non-cognitive mental ill health. As a professional
working in this area I share her concern and am of the view that
Rosemary is far from alone in her experience. When the Dementia
Strategies and Targets were first introduced in Scotland from 2010
onwards, it was my concern about this potential for inverse care, and for increased stigma associated with ageing, that led me to advocate publicly for a timely approach to the diagnosis of dementia.
I did so at a time when this approach had no support whatsoever from
policy makers, healthcare or the Mental Welfare Commission.

I thought that Angela Dias of “Action in Mind” spoke with clarity and genuine concern about what she termed “institutional discrimination” relating to older adults with mental health issues living in Scotland today.

The Principal Medical Officer for Scotland, Dr John Mitchell, acknowledged several times the evidence that those with chronic mental health disorders die 15-20 years earlier than those who do not. He stated at this meeting that this is a “huge finding, a universal finding, a huge inequity”.
Academics are increasingly of the view that one of the potential
reasons for such early death has been the prescribing of psychiatric
medications. This is why I mentioned a number of times at the meeting
the widely gathered evidence (PE1493, Sunshine Act for Scotland)
that the pharmaceutical industry continues to have a significant role
in the “education” of Scottish doctors in the prescribing of psychiatric
medications.

I thought the presentation by Dr David Christmas was most interesting
and share his concern that there is an imbalance in research studies
across the age ranges. I raised a number of questions with Dr
Christmas because he works as a “super-specialist” and so deals with a
very select group of patients.

At the Cross Party meeting Dr Christmas stated that “depression is under-recognised across all age groups” and that “maintenance treatment has a good risk-benefit ratio.” He did so without acknowledging that these statements cannot be made with absolute certainty.

I have attended a wide range of GMC-required Continuing Medical
Education (CME) and so over the years have found that I have attended a
number of educational talks given by Dr David Christmas. He always
carefully talks through his declarations of interest which for at least
the last five years do not include any financial interests other than
his employment with NHS Tayside as the Clinical lead of the Advanced Intervention Service.

Dr Christmas is a member of the Psychopharmacology Committee of the Royal College of Psychiatrists. The Chair of this most influential committee (in terms of the prescribing of psychiatric drugs) is Professor Allan Young, a “key opinion leader”. Professor Allan Young declares his extensive financial interests as follows:
“Paid lectures and Advisory Boards for all major pharmaceutical
companies with drugs used in affective and related disorders” . A similar key opinion leader, Professor Stephen Stahl, gave a keynote talk at the British Association of Psychopharmacology in 2015.
As he is American, and they have a Sunshine Act, it is possible to
establish Professor Stahl’s earnings from promoting psychiatric drugs.
When last looked at, this was, more than $3.5 million dollars. In the absence of a similar Sunshine Act in the UK we cannot establish the scale of payments made in the UK.

Dr Christmas has given educational lectures alongside Dr Hamish McAllister-Williams who is also a member of the Psychopharmacology Committee of the Royal College of Psychiatrists (RCPsych), and who was appointed in 2012 as Director of Education for the British Association of Psychopharmacogy (BAP).

Dr McAllister-Williams declares a wide range of financial interests with the Pharmaceutical Industry. Dr McAllister Williams is “a major contributor” to the RCPsych and BAP Continuing Professional Development programme.

It was with this knowledge, of the influential position that Dr
Christmas has in terms of the education of UK psychiatrists, that after
the Cross Party Meeting I wrote to ask Dr Christmas to ask if he might
support a Sunshine Act for Scotland? At the meeting Dr Christmas
took time to carefully address other biases (which I share his concern
about) but did not do the same for the financial biases that may affect
the advice given by key opinion leaders. The same potential exists for
research itself.

In my correspondence with Dr Christmas I reminded him that I
prescribe both antidepressants and antipsychotics but explain to
patients that the best evidence we have is generally based on short-term
studies and that all interventions (including psychological
interventions) can have both benefits and harms.

I have confirmed with Dr Christmas that I share his determination to
seek science that is as objective as possible and that this means that I
realise that biases do indeed come in all forms and not just financial.
I simply argue that science should be based on transparency or it
ceases to be science. My view is that it is not necessarily a bad thing
if doctors are paid for their time and expertise working outwith the
NHS. For example, working for NICE, or giving expert views to court.
However, when a doctor has a financial “conflict of interest”, this can affect the treatment decisions they make, or recommend.
These conflicts cannot be entirely avoided, and in many cases they are
entirely reasonable. However, it is important that information is
available on which companies have paid a doctor, so that colleagues and
patients can decide for themselves what they think. For example, there
is longstanding evidence that exposure to industry promotional activity can lead to doctors recommending worse treatments for patients.

I have also discussed with Dr Christmas the view that proportionality
of understanding should come in words as well as numbers and that the
quantitative and qualitative require ‘parity of esteem’.

In summary, I thought the Cross party meeting on Mental Health,
Ageing and Older People was an excellent opportunity for a range of
voices to share their thoughts and experiences. Such involvement is to
be commended and I hope that both my profession and policy makers of all
sorts may agree. ..."

"In the attached paper I explain why the Lesley
McDade affair provides further evidence that it is essential that there
be a full review of the 2003 Act. I also point out that yet again the
Scottish Government has failed to provide satisfactory answers to
written PQs. Finally I recommend that there be legislative reform in
Scotland in order to bring Scottish mental health and incapacity
legislation into line with modern human rights law, notably with the
Convention on the Rights of Persons with Disabilities, judgments of the
European Court of Human Rights and of the Supreme Court.

"Yesterday evening I received 5 Emails, forwarded on from a woman who is a
detained patient in a Scottish psychiatric hospital, not Fife. Dated
from 20-29 January 2016. Which I have forwarded on to colleagues, to
Colin McKay, Mental Welfare Commission, to MSPs in the woman's area, to
my MSP Roderick Campbell, and to VOX (voices of experience) and HUG
(Highland Users Group) contacts, for their information.
In these Emails the woman says that she is not mentally ill but is to be
subject to a forced depot injection fortnightly. And was given one
electroconvulsive therapy (ECT) treatment on the day she entered the
hospital. Her writing was lucid and made sense, containing observations
of what went on in the ward and issues arising.
I noticed that there were IT, knitting and pottery classes available.
Nothing like that was on offer at Stratheden Hospital, Fife, in 2012.
The female patient also said that independent advocacy was helpful and
that she managed to eventually obtain a solicitor to act on her behalf,
likely at a Mental Health Tribunal, appealing the 28 day detention.
The patient says that she was put on to a 28 day S44 short-term
detention, not a 72 hour one, "for the purpose of an Appeal under the
Act". And says that she always receives a depot injection on the
"premise" that she refuses to accept that she is mentally ill or that
the diagnosis is correct.
The Emails had long lists of points containing a variety of information
and detail, past and present. They were not addressed to me in person
but had been forwarded on so I assume that many other people also
received these Emails. I think it's very useful that this woman has
written about her daily experiences as a psychiatric patient on the
ward. A personal diary shared with the outside world."

Email
from W Hunter Watson, 2 November 2016, sent to Maureen Watt, Minister
for Mental Health and other MSPs, campaigners, activists, carers and
psychiatric survivors:"In the attached paper I emphasise that the lack of
effective safeguards in the 2003 Act taken in conjunction with recent
judgments of the European Court of Human Rights opens up the possibility
that any involuntary mental health patient could raise a court action
with a reasonable chance of success on the grounds that one or more of
his or her human rights had been breached. Given what happened when a
prisoner's court action led to the finding that being forced to "slop
out" constituted degrading treatment and hence breached Article 3 ECHR
it would be nigh certain that one successful court action by an
involuntary mental health patient would be followed by many more,
something that could result in the NHS paying out vast sums in
compensation.

As I have observed
previously, in the period from January 2016 to August 2016 only 1.8% of
the applications for a Compulsory Treatment Order were refused by the
Tribunal. This paper provides information which should help to explain
why that figure is so low. It quotes from three tribunal transcripts
which are in my possession. These transcripts demonstrate that the level
of proof at those particular tribunals was far too low. This is mainly
because tribunal members consider psychiatrists and MHOs to be credible
witnesses and are prepared to accept as fact any of their testimony. In
my opinion, not only are tribunal members failing in their duty by not
properly testing the evidence but they are demonstrating a measure of
gullibility by being prepared to accept as gospel whatever evidence that
is presented to them by a health professional. Sometimes the health
professional might honestly believe what he is saying to the Tribunal
even though it is untrue. On other occasions the health professional
will deliberately be attempting to mislead the Tribunal in an attempt to
persuade it to grant the sought for Compulsory Treatment Order. That
happened on several occasions in the hearings for which I have the
transcripts though I have only indicated one place in one transcript
where a witness knowingly gave false evidence. In my comments on the
transcripts I am also critical of the performance of the solicitor
representing the mental health patient. There was a woeful failure on
her part to attempt to test the evidence. No doubt the same criticism
could be made of other solicitors should other tribunal transcripts
become available for analysis.

There has been a reluctance on the part of the Scottish Government to
accept that the 2003 Act is not being implemented as Parliament had
intended. I trust that the attached paper will be sufficient to persuade
the Government that mental health tribunals are not effective
safeguards against mental health patients being improperly deprived of
their liberty and of being subjected to forced treatment which breaches
their right to respect for private life or even their right not to be
subjected to inhuman or degrading treatment. If the Government is
persuaded of this then obviously the Government should take steps to
address these serious issues.

I and
others look forward to seeing the report on the scoping study related to
the forthcoming review of Scottish mental health and incapacity
legislation. I cannot believe that it will fail to draw attention to the
need for significant changes in order to address important human rights
issues.

Thank you for copying me into this communication and the attached paper which I have now read.

I do hope the Minister will do her very best to provide some clarity to the questions that you raise.

I
think most that you circulated your paper to will be aware of my
successful petition to the Scottish Parliament for a Sunshine Act
(PE1493)which was closed after a public consultation. In a majority
the public asked that payments from commercial enterprises to
healthcare workers, researchers and academics are made available to the
public and that this needs to be on a “Mandatory” basis.

I
mention this, as I am of the view that it is a most important backdrop
to your paper. In the cases you outline in your paper, psychotropic
treatments have been given under the 2003 MH(S)A.

As
an NHS doctor working in Scotland I prescribe psychotropic medications
as appropriately as I can trying to follow the evidence base. I am
quite certain that healthcare workers all want to help anybody who is
suffering. I am also certain that no evidence base can ever be fully
complete. However we will not know if we are potentially doing unwitting
harm given the current level of commercial interests in NHS Scotland.
If anybody is in doubt, have a look at the evidence collected for
PE1493: https://holeousia.com/about-me/a-sunshine-act-for-scotland/

Given that current Scottish Guidance on this (HDL 62) has been ignored across Scotland for more than a decade
it is reasonable to be significantly concerned about this. I understand
that the Scottish Government are currently proceeding with this matter
following the closure of my petition in March of this year.

I mentioned evidence. Before signing off, I just want to make a few reminders of prescribing patterns in Scotland:

·1 in 7 Scottish adults are now on antidepressants. Mostly taking them long-term
it seems. Yet commercial interests only ever undertook short, 6 week
studies. There is thus a lot of unknowns about long-term prescribing of
antidepressants.

·Each
year, the prescribing of antipsychotics in Scotland, in all age groups,
is rising. This concerns me very much. These medications have a role in
reducing suffering but are also associated, most commonly with
significant, and potentially life-shortening, side-effects. Such use of
antipsychotics in our elders has been very widely promoted by the pharmaceutical industry
who developed the term “Behavioural and Psychological Symptoms in
dementia” (BPSD). The industry then promoted this use by “educating”
healthcare workers on “BPSD”. Today, healthcare workers are even more
likely to be “educated” by commercial interests, and indeed, “Continuing
medical Education” (CME) is a necessary part for doctor and nurse
annual appraisal. The commercial sector are exploiting this professional
requirement.

I
hope this summary Mr Watson is of some help to you, and that the
Minister may consider replying on the additional points I make.

We
do need the help of the Scottish Government here to make sure we can
achieve the best possible outcome when interventions are made whether
willing or unwillingly.

Introduction"SEAN 2015 ReportThe
acronym “SEAN” stands for “Scottish ECT Accreditation Network”. The
2015 SEAN report contains statements of a factual nature but it also
contains others which seem designed to divert the public from asking
serious questions about ethical and human rights issues related to ECT. A
study of the report also makes clear that the so-called legal
safeguards designed to protect patients are worthless. ..."

you have provided Jamie Hepburn with a copy of my paper
"Antipsychotic guidelines for dementia patients 2". I now attach reports
of two court judgments and would be grateful if you could draw these to
the attention of the Minister and suggest that either he reads them or
that he instructs his officials to do so. These judgments clearly have
implications for Scotland's mental health strategy.

In the judgment relating to a refusal of treatment the report correctly notes that the judge observed that "Every
adult capable of making decisions has an absolute right to accept or
refuse medical treatment, regardless of the consequences of the
decision. The decision does not need to be justified to anyone. Without
consent any invasion of the body, however well-meaning or therapeutic,
will be a criminal assault".

The
judge's observation should be assessed in conjunction with the GMC
consent guidance which stresses that there must be a presumption of
capacity :"You must only regard a patient as
lacking capacity once it is clear that, having been given all
appropriate help and support, they cannot understand, retain, use or
weigh up the information needed to make that decision, or communicate
their wishes". The judge's observation should also be assessed in
conjunction with Article 12 of the Convention on the Rights of Person's
with Disabilities and the General Comment on Article 12 issued by the UN
Committee on the Rights of Persons with Disabilities.

I am not aware of any health professional being prosecuted as a
consequence of having treated a patient without first having obtained
consent. I am aware, however, of successful civil actions being raised
by patients who suffered harm after being treated without having given
their informed consent. They had not objected to the proposed
treatment but might have done so had they been informed of the
significant risks associated with the treatment. I attach a report of
such a case. A jury in the USA awarded a woman $635,177 damages for
long-term memory loss following electroconvulsive therapy. Although the
report does not make the reason for the award completely clear it seems
that there was a failure to warn the woman about the risks and that is
likely to have been the main reason for making the award. It would have
been unreasonable to have awarded damages for memory loss if the woman
had been made well aware of that risk and had agreed to go ahead
regardless.

One implication of the
attached reports is that it is never appropriate to treat a competent
patient against his or her will. Hence section 242 should be deleted
when the 2015 Mental Health Act is amended as should that part of the
Act which permits electroconvulsive therapy to be given even if a
patient resists or objects to the treatment: ECT is not the safe and
effective treatment that its proponents claim it to be.

Evidence from those who supported petition PE01494 on mental health
legislation revealed that some psychiatrists made no serious attempt to
assess the capacity of their patients to make decisions about medical
treatment. The Code of Practice which replaces the Code for the 2003 Act
should emphasise that this situation must change and that health
professionals must seek not only consent, but also informed consent.

"The use of these drugs in those with dementia has substantial clinical
risk attached, including a conservative estimate of 1,800 extra deaths
and 820 extra serious adverse events such as stroke per year."
Sube Banerjee, Professor of Mental Health and Ageing, King's College London
Received this morning in an Email from Mr Watson, sent to an MSP and copied to others, including me:

Here
is a Paper received yesterday, written by Scottish mental health and
human rights activist Hunter Watson, Aberdeen, sent to Colin McKay, Chief Executive at Mental Welfare Commission for Scotland, copied in to various Members of the Scottish Parliament and other campaigners.

Hunter
Watson, Human Rights Campaigner, Aberdeen, in an Email sent to MSPs and
fellow mental health campaigners on 20 June 2015:

"In the attached paper I point out that section 242
of the 2003 Act authorises the compulsory treatment of an adult with
capacity. That is contrary to the advice of the Millan Committee, the
committee that produced the report upon which the 2003 Act is based.

The
paper also draws attention to the fact that a judgment of the European
Court of Human Rights makes it clear that the Court assumed that an
adult with capacity must not be subjected to compulsory treatment. That
was made explicit in a recent judgment of the Supreme Court.

Further, a
general comment made by UN Committee last year clearly demonstrates that
it takes it for granted that persons with legal capacity have the right
to refuse treatment. (Its only concern is that psychiatrists and others
might be too ready to assume that people with a mental disorder lack
capacity.)

There is a high
probability that section 242 of the 2003 Act is not compatible with some
Convention rights and hence, by virtue of section 29 of the Scotland
Act, that the 2003 Act is not law. The Minister should not be permitted
to evade making detailed responses to the points made in the attached
paper by again claiming that he is confident that the 2003 Act,
underpinned by the Millan principles, is compatible with the European
Convention on Human Rights. The Minister should instead put in place
without delay arrangements for conducting a wide review of the 2003 Act
as requested by Richard Simpson and the General Assembly of the Church
of Scotland.

I understand that the
Scottish Parliament will be discussing the Mental Health (Scotland) Bill
on Wednesday 24 June. I await with interest to find out whether the
Minister accepts that there is a need for a wide review of the 2003 Act
and also whether he is prepared to assure Parliament that the 2003 Act,
amended by the Mental Health Bill to form the 2015 Act, is compatible
with Convention rights. It would be wrong of him to offer Parliament any
such assurance."